本文關(guān)鍵詞： 血液透析 微炎癥 C反應(yīng)蛋白 血管緊張素轉(zhuǎn)換酶抑制劑 血管緊張素Ⅱ受體拮抗劑　出處：《中國血液凈化》2011年03期 　論文類型：期刊論文

【摘要】：目的探討維持性血液透析(maintenance hemodialysis,MHD)患者微炎癥狀態(tài)及其影響因素。方法檢測中國醫(yī)科大學(xué)附屬第一醫(yī)院血液凈化中心MHD的慢性腎衰竭患者51例作為MHD組,搜集這些患者的臨床資料;29例健康體檢者作為對照組。檢測血清C反應(yīng)蛋白(C-reactive protein,CRP)、血清白細(xì)胞介素6(interleukin-6,IL-6)、腫瘤壞死因子á(tumor necrosis factor-á,TNF-á),與對照組比較;檢測MHD組血清肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)、血紅蛋白(hemoglobin,Hb)、轉(zhuǎn)鐵蛋白(transferrin,TRF)、血清白蛋白(albumin,Alb)、碳酸氫根離子(HCO3-)等相關(guān)指標(biāo),并進行相關(guān)性分析。根據(jù)MHD組患者有無服用血管緊張素轉(zhuǎn)換酶抑制劑(angiotensin con-verting enzyme inhibitor,ACEI)/血管緊張素Ⅱ受體拮抗劑(angiotensinⅡreceptor blocker,ARB)藥物,將MHD組分為ACEI/ARB服用組和未服用組,比較2組之間CRP、IL-6、TNF-á之間有無差異。結(jié)果 MHD組與對照組比較,血CRP升高,分別為(8.88±8.46)mg/L和(0.80±0.20)mg/L;IL-6升高,分別為(10.57±5.25)pg/ml和(1.70±0.43)pg/ml;TNF-á升高,分別為(30.55±12.84)pg/ml和(11.36±3.14)pg/ml,差異均有統(tǒng)計學(xué)意義(均P0.01)。相關(guān)性分析表明,MHD組患者CRP與IL-6、TNF-á、BUN、SCr、透析齡呈顯著正相關(guān)(r=0.526,P0.01;r=0.511,P0.01;r=0.279,P0.05;r=0.287,P0.05;r=0.298,P0.05),與Alb、TRF、HCO3-呈明顯負(fù)相關(guān)(r=-0.573,P0.05;r=-0.46,P0.01;r=-0.479,P0.01),與Hb、患者年齡無顯著相關(guān)性。ACEI/ARB服用組與未服用組比較,血CRP降低,分別為(0.55±0.32)mg/L和(10.07±9.34)mg/L;IL-6降低,分別為(9.66±4.53)pg/ml和(14.24±6.69)pg/ml;TNF-á降低,分別為(26.36±11.25)pg/ml和(38.35±16.46)pg/ml,差異均有統(tǒng)計學(xué)意義(均P0.05)。結(jié)論 MHD患者存在微炎癥狀態(tài),作為描述MHD患者微炎癥狀態(tài)比較好的生化指標(biāo)CRP,與患者透析齡、血HCO3-有一定的相關(guān)性。微炎癥狀態(tài)對MHD患者營養(yǎng)狀況有重要影響。ACEI/ARB藥物能改善MHD患者微炎癥狀態(tài)。
[Abstract]:Objective to investigate the maintenance of hemodialysis in maintenance hemodialysis. Methods 51 patients with chronic renal failure (MHD) in blood purification center of the first affiliated Hospital of China Medical University were selected as MHD group. Collect the clinical data of these patients; The serum C-reactive protein (CRP) was measured in 29 healthy persons as control group. Serum interleukin-6 (IL-6) and tumor necrosis factor- (TNF-). Compared with the control group; The serum creatinine, serum creatinine and blood urea nitrogenbun in MHD group were detected. Hemoglobin (HB), transferrin transferrin (TRFF), serum albumin (Alb). Bicarbonate ion (HCO3) and other related indexes. According to whether the patients in MHD group have taken angiotensin converting enzyme inhibitor (ACE). Angiotensin con-verting enzyme inhibitor. ACEI / angiotensin 鈪，

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